Ovulation Research Articles

Maternal undernutrition in the first eighty days of gestation negatively programs ovarian development in dairy calves.

We hypothesized that in dairy cattle maternal energy restriction applied during two gestational windows (up to day 80 or 120 of gestation) impairs ovarian and cardiovascular development in juvenile female offspring. We also investigated the role of maternal leptin and testosterone in developmental programming in calves. Holstein-Friesian heifers were randomly assigned to one of three experimental groups; starting 10days before artificial insemination, they were individually fed at: (i) 0.6 of their maintenance energy requirements (M) up to day 80 (Nutrient Restricted, NR80) or (ii) day 120 of gestation (NR120); (iii) 1.8M until day 120 of pregnancy (Control, CTR). Plasma leptin concentrations increased transiently in nutritionally restricted heifers pregnant with a single female calf, but maternal testosterone concentrations were not influenced by diet. Calves had similar body growth, but daughters of NR80 and NR120 had impaired ovarian development, as assessed by reduced gonadal weight, fewer surface antral & primary follicles and recovered COCs, as well as lower circulating AMH concentrations. Cardiovascular morphology and function in the offspring were not influenced by maternal diet, as determined by peripheral arterial blood pressure, echocardiography, post-mortem heart weight and aortic circumference. Regardless of its duration (until day 80 or 120 of gestation), nutritional restriction resulted in a similar alteration of ovarian development in juvenile progeny, but cardiovascular development was unaltered. Evidence suggests that the window of development that encompasses the peri-ovulatory period to the first 2.6months of gestation is critical in ovarian programming and that maternal leptin may be involved.

Periovulatory PM2.5 constituent exposures and human clinically recognized early pregnancy loss: Susceptible exposure time windows and high–risk constituents

Evidence for effects of PM2.5 chemical constituent exposures during the periovulatory period on pregnancy complications was limited. We explored the associations of maternal PM2.5 and constituent exposures from the 12th week before to 4th week after ovulation with human clinically recognized early pregnancy loss (CREPL). From July 2017 to January 2024, 828 CREPL and 828 normal early pregnancy (NEP) participants were recruited in Tianjin, China. Daily residential exposures to PM2.5 and five main constituents of all participants were estimated using data of the Tracking Air Pollution in China platform. Nonlinear and linear associations between weekly pollutant exposures and CREPL were estimated using conditional logistic regression models combined with distributed lag nonlinear and distributed lag models, respectively. The risk of CREPL increased with per 10 μg/m³ increment in PM2.5 and per 1 μg/m³ increment in sulfate, nitrate, and ammonium exposures during specific weeks from the 5th week before to 2nd week after ovulation, with the largest OR (95% CI) of CREPL associated with PM2.5, sulfate, nitrate, and ammonium being 1.73 (1.07, 2.78), 1.71 (1.18, 2.46), 1.80 (1.12, 2.90), and 1.61 (1.01, 2.56), respectively. CREPL was positively associated with the 10th to 90th percentiles exposure to organic matter during the 2nd and 3rd week after ovulation. In analyses for constituent residuals, the five constituents were all independently related to CREPL, with organic matter being the highest risk constituent, and nitrate and ammonium affecting at the initial stage of preantral follicle development. In conclusion, periovulatory PM2.5 and constituent exposures were associated with increased risk of CREPL. Women planning a pregnancy are advised to take exposure precautions starting from the follicular development period.

The influence of menstrual cycle phase on isokinetic knee flexor and extensor strength in female soccer players: a pilot study

ABSTRACT The prevalence of anterior cruciate ligament injury in female soccer players has been attributed to hormonal fluctuations during the menstrual cycle (MC), with injury incidence greatest during the follicular phase. Eight, eumenorrheic, collegiate soccer players (19.5 ± 0.75 years, 1.62 ± 4.90 cm, 61.12 ± 7.6 kg mean ± SD) completed eccentric knee flexor and concentric knee extensor trials at 60 and 240°·s−1 during the follicular, ovulation and luteal phases of their MC. Peak torque and corresponding angle of peak torque were maintained across all phases of the MC, irrespective of testing modality and speed (p ≥ 0.149). Strength ratios defined using peak torque were also not sensitive to MC phase (p ≥ 0.933). However, Functional Range in eccentric knee flexion was significantly lower during the follicular phase (p = 0.017), at both testing speeds. This supports epidemiological observations but highlights the importance of analysing isokinetic data beyond the peak of the strength curve. Interpretation of isokinetic data should therefore focus on points of “weakness” as opposed to maximum strength, whilst (p)rehabilitative strategies should consider strength through range of motion, and at different speeds. Eccentric hamstring strength was observed to decrease significantly at the higher speed, contrary to observations in elite male players, and potentially reflecting a differential training adaptation.

AKTIVITAS FISIK DAN PERUBAHAN SIKLUS MENSTRUASI

The menstrual cycle is one aspect of assessing female reproductive function, changes in the menstrual cycle can occur in women in their 20s due to irregular ovulation phases, changes in the menstrual cycle are influenced by several factors, one of which is physical activity. Physical activity of Nursing Study Program students at Tanjungpura University Pontianak varies from studying in class, laboratory, clinical practice in hospitals, other activities such as exercising. The purpose of this study was to determine the correlation between physical activity and changes in the menstrual cycle. This study is a quantitative study with a cross sectional approach on 100 respondents with total sampling technique, and data collection using IPAQ questionnaire and menstrual cycle questionnaire. Data analysis used frequency distribution and chi-square test. Physical activity of female students was mostly in the high category as many as 76 respondents (76.0%) of 100 respondents, the menstrual cycle of female students was mostly irregular as many as 80 respondents (80.0%) of 100 respondents. The results of the chi-square test showed that there was no correlation between physical activity and changes in the menstrual cycle in nursing students of Tanjungpura University Pontianak, with a p-value of 0.292 (p-value> 0.05), the correlation coefficient was positive with a value of 0.105. There is no correlation between physical activity and changes in the menstrual cycle of nursing students of Tanjungpura University Pontianak.

Evaluation of auditory middle latency response during the menstrual cycle

Aim: The hormone levels during the menstrual cycle, directly and indirectly, affect the hearing system. In our study, it was aimed to examine the effects of changing hormone levels during the menstrual cycle on auditory middle latency responses in healthy individuals with different stimuli types and the psychosomatic effects of premenstrual complaints on auditory performance. Methods: In the study, 20 healthy women aged 18-35 years, with regular menstrual cycles and no auditory or vestibular complaints were evaluated for auditory middle latency responses with click and level-specific (LS) CE-Chirp® stimuli during the menstruation period of the follicular phase (1-5 day, menstrual phase), the ovulation phase (14-17 day) and the luteal phase (21-28 day). To evaluate the effect of premenstrual complaints on auditory performance, the participants were asked 5 questions. Results: In the auditory middle latency assessment with click stimuli, a statistically larger Na-Pa amplitude was obtained in the menstruation phase compared to the ovulation phase in both ears. In the auditory middle latency evaluation with LS CE-Chirp® stimulus, statistically shortened Nb latencies were obtained in the right ear in the menstruation phase compared to the ovulation phase. Conclusion: Although the clear effect of changing gonadal hormone levels on auditory evoked middle latency responses could not be determined, the findings show that neural transmission increases in the menstrual phase when the estrogen level is low. Click stimulus is more sensitive to hormonal changes, and the use of click stimulus has been recommended in the later side of lesion studies. In our study, no psychosomatic effect of complaints in the premenstrual period on auditory performance was observed.

Diffuse Uptake of 68Ga-Pentixafor in the Breasts During the Ovulatory Phase in a Patient With SAPHO Syndrome.

We report a case of a woman with SAPHO syndrome who exhibited increased tracer uptake in the sternal angle on a 99mTc-MDP bone scan. This patient was enrolled in a 68Ga-pentixafor PET/CT trial for inflammatory diseases. The PET/CT showed no abnormal tracer uptake in the sternal angle. Unexpectedly, diffuse uptake of 68Ga-pentixafor was observed in both breasts, which might be due to hormonal stimulation because the woman underwent the 68Ga-pentixafor PET/CT scan during the ovulatory phase.

New insights into the ovulatory process in the human ovary.

Successful ovulation is essential for natural conception and fertility. Defects in the ovulatory process are associated with various conditions of infertility or subfertility in women. However, our understanding of the intra-ovarian biochemical mechanisms underlying this process in women has lagged compared to our understanding of animal models. This has been largely due to the limited availability of human ovarian samples that can be used to examine changes across the ovulatory period and delineate the underlying cellular/molecular mechanisms in women. Despite this challenge, steady progress has been made to improve our knowledge of the ovulatory process in women by: (i) collecting granulosa cells across the IVF interval, (ii) creating a novel approach to collecting follicular cells and tissues across the periovulatory period from normally cycling women, and (iii) developing unique in vitro models to examine the LH surge or hCG administration-induced ovulatory changes in gene expression, the regulatory mechanisms underlying the ovulatory changes, and the specific functions of the ovulatory factors. The objective of this review is to summarize findings generated using in vivo and in vitro models of human ovulation, with the goal of providing new insights into the mechanisms underlying the ovulatory process in women. This review is based on the authors' own studies and a search of the relevant literature on human ovulation to date using PubMed search terms such as 'human ovulation EGF-signaling', 'human ovulation steroidogenesis', 'human ovulation transcription factor', 'human ovulation prostaglandin', 'human ovulation proteinase', 'human ovulation angiogenesis' 'human ovulation chemokine', 'human ovulatory disorder', 'human granulosa cell culture'. Our approach includes comparing the data from the authors' studies with the existing microarray or RNA-seq datasets generated using ovarian cells obtained throughout the ovulatory period from humans, monkeys, and mice. Current findings from studies using in vivo and in vitro models demonstrate that the LH surge or hCG administration increases the expression of ovulatory mediators, including EGF-like factors, steroids, transcription factors, prostaglandins, proteolytic systems, and other autocrine and paracrine factors, similar to those observed in other animal models such as rodents, ruminants, and monkeys. However, the specific ovulatory factors induced, their expression pattern, and their regulatory mechanisms vary among different species. These species-specific differences stress the necessity of utilizing human samples to delineate the mechanisms underlying the ovulatory process in women. The data from human ovulation in vivo and in vitro models have begun to fill the gaps in our understanding of the ovulatory process in women. Further efforts are needed to discover novel ovulatory factors. One approach to address these gaps is to improve existing in vitro models to more closely mimic in vivo ovulatory conditions in humans. This is critically important as the knowledge obtained from these human studies can be translated directly to aid in the diagnosis of ovulation-associated pathological conditions, for the development of more effective treatment to help women with anovulatory infertility or, conversely, to better manage ovulation for contraceptive purposes. N/A.

Changes in muscle cross-sectional area during two menstrual cycles may not be exclusively attributed to resistance training

This study investigated the impact of menstrual cycle (MC) phases and resistance training (RT) on muscle cross-sectional area (CSA) in two MCs utilizing a within-subject design. Twenty women with regular MCs had their legs randomly allocated to either the control (CON) or RT condition, which included 16 training sessions over two MCs. CSA, estradiol (E2), and progesterone (P4) were assessed during the menstruation (M), ovulation (O), and luteal (L) phases in the first (M1, O1, L1) and second (M2, O2, L2) MCs and at the beginning of the third MC (M3). P4 values were significantly higher during the luteal phase than during menstruation (P < 0.0001) and ovulation (P < 0.0001). No significant differences in E2 concentrations were observed between the MC phases (P = 0.08). For the RT condition, the CSA showed significant increases at O2, L2, and M3 compared to baseline (M1) (all P < 0.0001). No significant changes were observed for the CON condition during the two MCs (P > 0.05). However, RT condition showed a significant change in average CSA across two MCs. Additionally, individual analyses revealed that 19 participants showed variation in CSA above or below the minimum detectable difference during the two MCs. These findings suggest that changes in muscle CSA observed during two MCs may not be exclusively attributed to RT.

Current Ovulation and Luteal Phase Tracking Methods and Technologies for Fertility and Family Planning: A Review

AbstractOvulation is critical for both conception and overall health, but many people who may ovulate are not tracking ovulation or any other part of their menstrual cycle. Failure to track ovulation, especially in those trying to conceive, can lead to fertility challenges due to absent ovulation, mistiming intercourse, or an undetected luteal phase defect. Ovulatory disorders and mistiming intercourse are both primary causes of infertility, and tracking ovulation is shown to decrease the average time to conception. While there are many tracking methods and apps available, the majority are predictive apps or ovulation predictor kits and do not test or track both successful ovulation and the health of the luteal phase, leading to missing information that could contribute to diagnosis or successful conception. Here, we review why ovulation tracking and a healthy luteal phase are important for those trying to conceive. We present currently available ovulation tracking methods that detect both ovulation and the luteal phase, including cervical mucus, urinary hormone testing, and basal body temperature, and discuss the use, advantages, and disadvantages of each. Finally, we consider the role of digital applications and tracking technologies in ovulation tracking.

A novel intrauterine estrogen-releasing system for preventing the postoperative recurrence of intrauterine adhesion: a multicenter randomized controlled study

BackgroundTranscervical resection of adhesions (TCRA) is the standard treatment for intrauterine adhesion (IUA). Previous studies have shown that postoperative oral estrogen or an intrauterine physical barrier could reduce the recurrence of IUA by promoting the proliferation of the endometrium or inhibiting the reformation of adhesions. Our team designed an intrauterine stent that can release estrogen within the uterine cavity slowly. In this study, we aimed to investigate the efficacy and safety of the estrogen-releasing intrauterine system in preventing the recurrence of moderate to severe IUA.MethodsThis was a multicenter prospective randomized controlled 2-arm parallel trial that included patients who were diagnosed with moderate to severe IUA and who received TCRA. A total of 250 patients were randomly assigned, at a 1:1 ratio, to receive the intrauterine estrogen-releasing system or a Foley catheter balloon combined with oral estrogen therapy after surgery. The primary outcome was the rate of adhesion reduction in the two groups. The secondary outcomes included endometrial thickness at the ovulation period, menstrual improvement rates, and other reported adverse events during follow-up.ResultsThe average daily drug release amount for all the tested stents was 0.21 mg/day. At 60 days postoperatively, the rate of adhesion reduction was significantly greater in the experimental group than in the control group (93.33% vs. 58.56%, p < 0.001). The endometrium of the experimental group was thicker than that of the control group (p < 0.001). Consistently, the rate of improvement in menstruation was greater in the experimental group than in the control group (p = 0.010). No grade 3–4 adverse events were found in the two groups during the 1-year follow-up.ConclusionsIn the cohort of patients with moderate to severe IUA, the intrauterine estrogen-releasing system was more effective at reducing adhesion than traditional oral estrogen combined with an intrauterine Foley catheter after TCRA. This novel intrauterine system provides a new option for the management of IUA after surgery.Trial registrationThe registration number is NCT04972032. Date of registration: August 15, 2021.

Effect of early postmenopause and premenopause on resting-state electroencephalographic and their correlation with ovarian hormone levels.

This study aimed to compare the effect of the early postmenopausal period on resting-state electroencephalographic spectral power with that of the premenopausal period and to analyze the correlation between electroencephalographic spectral power values and endogenous ovarian hormone levels. This study involved 13 early postmenopausal women and 10 premenopausal women in the early follicular, 10 in the ovulatory phase, and 10 in the early luteal phase who underwent resting-state quantitative electroencephalographic spectral power with eyes closed and endogenous ovarian hormone measurements. The delta, theta, alpha1, alpha2, beta1, and beta2 absolute power were compared between the early postmenopausal and premenopausal groups. Correlations between electroencephalographic spectral power values and 17β estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone levels were analyzed in early postmenopausal women. Compared with the premenopausal group, the early postmenopausal group showed significantly higher resting-state theta power in the frontal region, alpha1 and alpha2 power in the frontal and central regions, beta1 power in the frontal, central, parietal, and occipital regions, and beta2 power in the centroparietal region. Beta2 power values were positively correlated with FSH levels. The current findings highlight that early postmenopausal women show greater resting-state alpha and beta power, which suggests cortical excitability of fast frequency bands involved in states of alertness, focus of attention, cognition, and emotion. Additionally, we emphasized the effect of FSH levels on fast cortical activation in early postmenopausal women.

The influence of physiological and functional characteristics of the body of girls aged 17-18 years on playing sports

Achieving competitive results in women’s sports for athletes aged 17-18 requires structuring training processes around their physiological characteristics. This article analyzes recent scientific data on the impact of sexual dimorphism in girls aged 17-18 on sports participation and training. Relevant scientific works from the past five years were collected and analyzed. At this age, girls undergo the final stage of sexual maturation. The effectiveness of sports activities varies individually, influenced by the ovarian-menstrual cycle, hormonal background, and symptoms in each cycle phase. Physical activity declines during the menstrual, ovulatory, and premenstrual phases, while postmenstrual and postovulatory phases are more favorable for sports participation. Performance indicators depend on sexual dimorphism: female athletes show unique features in central nervous system activity, high psycho-emotional excitability, and earlier development of somatic and physical qualities compared to males. The skeletal structure in 17-18-year-old female athletes is smaller and shorter, with a wider pelvis and more developed shoulder girdle. These findings can be used by sports schools, rehabilitation specialists, coaches, and sports physicians to adapt and structure training processes, taking into account the physiological characteristics of 17-18-year-old female athletes, aiming for highly competitive results. Keywords: Sexual Dimorphism, Hormonal Changes, Women’s Sports, Physical Culture, Sports Performance.

Associations of luteal phase changes in vagally mediated heart rate variability with premenstrual emotional changes

BackgroundA recent meta-analysis revealed that vagally mediated heart rate variability (vmHRV; a biomarker of emotion regulation capacity) significantly decreases in the luteal phase of the menstrual cycle. As two follow-up studies suggest, these vmHRV decreases are driven primarily by increased luteal progesterone (P4). However, analyses also revealed significant interindividual differences in vmHRV reactivity to the cycle, which is in line with longstanding evidence for interindividual differences in mood sensitivity to the cycle. The present study begins to investigate whether these interindividual differences in vmHRV cyclicity can explain who is at higher risk of showing premenstrual emotional changes. We expected a greater degree of midluteal vmHRV decrease to be predictive of a greater premenstrual increase in negative affect.MethodsWe conducted an observational study with a naturally cycling community sample (N = 31, M = 26.03 years). Over a span of six weeks, participants completed (a) daily ratings of negative affect and (b) counterbalanced lab visits in their ovulatory, midluteal, and perimenstrual phases. Lab visits were scheduled based on positive ovulation tests and included assessments of baseline vmHRV and salivary ovarian steroid levels.ResultsIn line with previous research, multilevel models suggest that most of the sample shows ovulatory-to-midluteal vmHRV decreases which, however, were not associated with premenstrual emotional changes. Interestingly, it was only the subgroup with luteal increases in vmHRV whose negative affect markedly worsened premenstrually and improved postmenstrually.ConclusionThe present study begins to investigate cyclical changes in vmHRV as a potential biomarker of mood sensitivity to the menstrual cycle. The results demonstrate a higher level of complexity in these associations than initially expected, given that only atypical midluteal increases in vmHRV are associated with greater premenstrual negative affect. Potential underlying mechanisms are discussed, among those the possibility that luteal vmHRV increases index compensatory efforts to regulate emotion in those with greater premenstrual negative affect. However, future studies with larger and clinical samples and more granular vmHRV assessments should build on these findings and further explore associations between vmHRV cyclicity and menstrually related mood changes.

Mature oocyte found during ovarian tissue cryopreservation in an early adolescent female.

A 15-year-old female with Hodgkin's lymphoma underwent ovarian tissue cryopreservation for preserving fertility in Reproductive Department of Sir Run Run Shaw Hospital, Zhejiang University School of Medical after receiving one course of chemotherapy. During the ovarian tissue cryopreservation, one MⅡmature oocyte and three germinal vesicle oocytes were found. The three immature oocytes underwent in vitro maturation but failed. Ultimately, one mature oocyte and 12 ovarian cortex slices were cryopreserved using vitrification. This case indicates that for patients with established gonadal axis feedback, ovarian tissue cryopreservation may not be the only method for fertility preservation. It is advisable to consider ovarian stimulation and oocyte retrieval for oocyte cryopreservation. Alternatively, for individuals in the ovulation phase of their menstrual cycle, attempting oocyte retrieval before ovarian tissue cryopreservation to obtain mature oocytes from the natural cycle, followed by oocyte cryopreservation, may enhance the likelihood of successful fertility preservation.

An observational study to evaluate Rutumati Lakshnas during ovulation period in different Prakruti

An observational study to evaluate Rutumati Lakshnas during ovulation period in different Prakruti

Loss of bmp15 function in the seasonal spawner Atlantic salmon results in ovulatory failure.

Bone morphogenetic protein 15 (BMP15) is an oocyte-specific growth factor important for successful female reproduction in mammals. While mutations in BMP15/Bmp15 cause ovulatory deficiency and/or infertility in certain mammalian species, loss of bmp15 in zebrafish, a continuous spawner and the only bmp15 knockout model in fish to date, results in complete arrest of follicle development and later female-to-male sex reversal, preventing to examine effects on ovulation/fertilization. Here, we used Atlantic salmon, a seasonal spawner, and generated bmp15 mutants to investigate ovarian development and fertility. Histological and morphometric analyses revealed that in biallelic frameshift (bmp15 fs/fs) mutant ovaries, folliculogenesis started earlier, resulting in an advanced development compared to wild-type (WT) controls, accompanied by a weaker expression of the (early) oocyte-specific factor figla. This precocious ovarian development was followed in bmp15 fs/fs females by enhanced follicle atresia during vitellogenic stages. Although genes involved in steroid synthesis and signaling (star, cyp11b, cyp17a1 and esr1) were dramatically higher in late vitellogenic bmp15 fs/fs mutant ovaries, estradiol-17β plasma levels were lower than in WT counterparts, potentially reflecting compensatory changes at the level of ovarian gene expression. At spawning, bmp15 fs/fs females displayed lower gonado-somatic index values and reduced oocyte diameter, and the majority (71.4%), showed mature non-ovulating ovaries with a high degree of atresia. The remaining (28.6%) females spawned eggs but they either could not be fertilized or, upon fertilization, showed severe malformations and embryonic mortality. Our results show that Bmp15 is required for proper follicle recruitment and growth and later ovulatory success in Atlantic salmon, providing an alternative candidate target to induce sterility in farmed salmon. Moreover, since loss of bmp15 in salmon, in contrast to zebrafish, does not result in female-to-male sex change, this is the first mutant model in fish allowing further investigations on Bmp15-mediated functions in the ovulatory period.

Protease expression in the human and rat cumulus-oocyte complex during the periovulatory period: a role in cumulus-oocyte complex migration†.

The migratory and matrix-invading capacities of the cumulus-oocyte complex have been shown to be important for the ovulatory process. In metastatic cancers, these capacities are due to increased expression of proteases, however, there is limited information on protease expression in the cumulus-oocyte complexes. The present study examined cumulus-oocyte complex expression of plasmins, matrix metalloproteases, and A Disintegrin and Metalloproteinase with Thrombospondin Motifs family members in the rat and human. In the rat, human chorionic gonadotropin (hCG) administration increased cumulus-oocyte complex expression of Mmp2, Mmp9, Mmp13, Mmp14, Mmp16, Adamts1, and the protease inhibitors Timp1, Timp3, and Serpine1 by 8-12h. This ovulatory induction of proteases in vivo could be mimicked by forskolin and ampiregulin treatment of cultured rat cumulus-oocyte complexes with increases observed in Mmp2, Mmp13, Mmp14, Mmp16, Mmp19, Plat, and the protease inhibitors Timp1, Timp3, and Serpine1. Comparison of expression between rat cumulus-oocyte complexes and granulosa cells at the time of ovulation showed decreased Mmp9 and increased Mmp13, Mmp14, Mmp16, Adamts1, Timp1, and Timp3 expression in the cumulus-oocyte complexes. In human, comparison of expression between cumulus and granulosa cells at the time of in vitro fertilization retrieval showed decreased MMP1, MMP2, MMP9, and ADAMTS1, while expression of MMP16, TIMP1, and TIMP3 were increased. Treatment of expanding rat cumulus-oocyte complexes with a broad spectrum matrix metalloproteases inhibitor, GM6001, significantly reduced the migration of cumulus cells in vitro. These data provide evidence that multiple proteases and their inhibitors are expressed in the cumulus-oocyte complex and play an important role in imparting the migratory phenotype of the cumulus-oocyte complex at the time of ovulation. Summary Sentence Multiple proteases and their inhibitors are induced in the cumulus-oocyte complex (COC) during the periovulatory period and potentially play an important role in imparting the migratory phenotype of the COC at the time of ovulation.

Ayurvedic Management of Multifactorial Female Infertility – A case report

Introduction: Infertility is a medical condition that can cause psychological, physical, mental, spiritual, and medical detriments to the patient. “Infertility is defined as failure to conceive within one or more years having regular unprotected coitus. All types of female Infertility in Ayurveda are described under the heading of Vandhya. According to Acharya Sushruta, there are four factors responsible for creation of Garbha i.e. Ritu (Ovulatory period/ period for copulation), Kshetra (reproductive tract including Uterus, Fallopian tube, Ovary), Ambu (Nutritive fluid for fertilized ovum), Beeja (Shukra &amp; Shonita i.e. Sperm &amp; Ovum). Among these four factors tubal blockage can be considered as the deformity of Kshetra i.e. Kshetradushti and Low level of Anti mullerian hormone can be compared to Dhatukshayajanya Vandhyatav. Aim and Obejctive: This case study was done to treat multifactorial female infertility with Ayurvedic treatment protocol and provide better quality of life. Methodology: A female Patient of 28 years of age, came to OPD of Prasuti Tantra Evum Stree roga with complaint of inability to conceive since 2 years of unprotected intercourse. Patient was diagnosed with female infertility due to bilateral tubal blockage, and low AMH level treated by Ayurvedic intervention i.e. - Virechana Karma, Yuktaratha Basti (3 days) along with Uttarabasti with Apamargkshara Taila (6 days) and Nagakesara Choorna orally (after stopping of menstrual bleeding). Result: Female infertility cured after treatment and conception achieved. Discussion: Ayurvedic approach would be beneficial in conservative management of tubal blockage and has an effective result in female infertility.

P-319 Chronic endometritis prevalence, associated factors and pregnancy outcome among infertile women

Abstract Study question What are the prevalence, associated factors and pregnancy outcome of chronic endometritis(CE) among infertile women? Summary answer The overal prevalence of chronic endometritis in infertile women was 24.7%. Diagnosis rate of CE was higher in primary infertility compared to other infertility groups. What is known already Chronic endometritis is defined as a chronic inflammation of uterine endometrium. The prevalence of chronic endometritis varies across different groups and diagnostic criteria. The pathophysiology of chronic endometritis remained unclear, therefore, associated factors of chronic endometritis are uncertain. Study design, size, duration We perfomed an single-center, retrospective study between May 2019 and July 2023. By doing so, we collected data on 486 infertile women. Participants/materials, setting, methods A total of 486 infertile women, who underwent hysteroscopy by single surgeon, were recruited. The diagnosis of chronic endometritis was confirmed by presence of plasma cell per section in hematoxylin-eosin stain or CD138 immunohistochemical staining. Preoperative information (including age, body mass index, smoking, alcohol consumption, clinical presentation of infertility, endometrial thickness at ovulatory phase, anti-mullerian hormone (AMH) level and infertility factors) and post-operative information (including endometrial histology and pregnancy outcome) were collected. Main results and the role of chance The prevalence of chronic endometritis in the 486 infertile women with hysteroscopy guided endometrial biopsy was 24.7%. Prevalence of chronic endometritis was 28.1%, 19%, 22.2%, 27.2% in women with primary infertility, secondary infertility, recurrent pregnancy loss (RPL) and repeated implantation failure (RIF), respectively. A multivariate analysis revealed that overweight was associated with lower risk of chronic endometritis than underweight (relative risk (RR) = 0.56, 95% confidence interval (CI): 0.32-0.98, p = 0.042). Primary infertility was associated with higher risk of chronic endometritis than non-primary infertility (RR = 1.44, 95% CI: 1.02-2.03, p = 0.039). The pregnancy rate (including spontaneous pregnancies) was comparable between women with treated chronic endometritis and without chronic endometritis; 54.7% versus 61.7% in clinical pregnancy rate and 82.8% vs 85.4% in ongoing pregnancy rate. The prevalence of chronic endometritis with coexisting endometrial lesion (endometrial polyps, submucous myoma, or both of them) was 61.7%. Limitations, reasons for caution Our retrospective study has a less powerful design compared to a prospective randomized controlled study. Wider implications of the findings In women with primary infertility, the diagnosis rate of chronic endometritis was higher compared to other infertility groups. Therefore, even in cases of primary infertility, chronic endometritis should be considered as a potential cause of infertility. Trial registration number not applicable

P-775 What is the potential of cervicovaginal mucus as a biomarker for identifying the fertile window and the effectiveness of AI-enhanced prediction for scalability and accessibility?

Abstract Study question What is the potential of cervicovaginal mucus as a biomarker for identifying the fertile window and the effectiveness of AI-enhanced prediction for scalability and accessibility? Summary answer Cervicovaginal mucus is a reliable biomarker for the fertile window. AI Foundation models show promise in enhancing this method’s scalability and predictability. What is known already The timing of ovulation corrosponds to the fertile window. Although modern methods of ovulation detections yield high accuracies, they often require the purchase of sensors/equipment which creates a barrier to those in low-resource settings. Natural fertility awareness based methods, such as CVM monitoring, eliminate this problem, but there are limited recent large-scale studies validating cyclical CVM changes. Digitising CVM monitoring could remove the subjectivity of the interpretation of symptoms. Despite the advances of AI in other FABM areas, limited work has been done on computer vision models for CVM evaluation, which could revolutionise accessibility and scalability, particularly in low-resource settings. Study design, size, duration The study involved analysis of self-reported CVM characteristics data from over 57,000 individuals; largest sample size used in any study investigating the use of CVM as a biomarker. Furthermore, a dataset of CVM images were collected from the public survey and labeled manually (n = 13). The study included retrospective and pilot components, employing statistical analyses like ANOVA, chi-squared, and Spearman correlation, and AI techniques like zero-shot learning for binary segmentation of CVM from smartphone-captured images Participants/materials, setting, methods Self-reported CVM data was obtained from a fertility tracking app and analysed using ANOVA and chi-squared tests to identify and validate findings of cyclical variations, and correlation with lifestyle data. Zero-shot learning was employed using foundation models. An ethically-reviewed survey was generated to collect images for subsequent model training Images from the survey were segmented using the Grounding DINO and the SAM. The surface area and elasticity extracted are used to determine the fertility score. Main results and the role of chance In individuals with 28-day cycles, CVM showed significantly higher quality during the ovulatory phase, marked by increased elasticity (p = 0.00001), amount (p = 0.00001)), and lubricative texture (p &amp;lt; 0.0001), when compared to both the follicular and luteal phases. However, variations in individuals with longer, irregular cycles of over 35 days length, were less pronounced. Age was found to significant positive correlation with overall CVM quality (r = 0.06, p &amp;lt; 0.0001), while no significant correlations were observed with smoking (r = 0.11, p = 0.23), alcohol consumption (r = 0.13, p = 0.17), or BMI (r = 0.006, p = 0.41)). Zero-shot learning for segmentation showed improved accuracy in detecting and extracting CVM from images, with precision of 0.867 and F1 score of 0.929, highlighting the model’s ability to correctly distinguish between CVM patterns corresponding to fertile and infertile status. The intersection over union score suggested consistent model performance. Overall, CVM emerged as a scalable fertility biomarker in typical menstrual cycles, with AI models showing potential for enhancing prediction accuracy and scalability. Limitations, reasons for caution The study’s limitations include its reliance on self-reported CVM data and the potential bias in the foundation models as there was no fine-tuning, due to a small dataset (n = 13). Additionally, the effectiveness of CVM as a biomarker in irregular menstrual cycles and subfertility requires further exploration. Wider implications of the findings Automated analysis of CVM can be a low-cost, scalable (potentially to millions, via mobile application), non-invasive method for fertility awareness. Our findings highlight the potential of AI in empowering fertility awareness, especially in low-resource settings with little access to reproductive healthcare, thus contributing to global health equity. Trial registration number n/a